Enfermedad de Vogt-Koyanagi-Harada

Frutos, Anne Riveros; Romero, P. Romera; Pérez, Susana Holgado; Escalona, José Ramón Anglada; Martínez-Morillo, Melania; Segura, Beatriz Tejera

doi:10.1016/j.semreu.2012.07.004

Cited by 7 publications

(4 citation statements)

References 17 publications

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“…Our patient developed steroid-induced hyperglycemia and diabetes insipidus shortly after corticosteroid use, a drug that has been associated with a wide range of adverse effects that has been increasing in incidence with chronic use [ 13 ]. Pituitary gland changes consistent with diabetes insipidus in a VKH patient is an association that was mentioned once in the literature before [ 14 ]. Hyperglycemia is a major concern when taking systemic corticosteroids even with short-term use, which is believed to be due to an increase in insulin resistance [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Complete Loss and Partial Regeneration of Photoreceptor Layers in a Pediatric Vogt-Koyanagi-Harada (VKH) Case

Aldossari¹,

Alhussaini²,

Barri³

et al. 2022

Cureus

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Vogt-Koyanagi-Harada (VKH) disease is a multisystem autoimmune disease affecting melanocytecontaining tissues in the eyes, meninges, ear, and skin. As far as we are aware, this is a unique case report documenting the regeneration of the photoreceptor layer after bilateral complete loss of the photoreceptor layer in a child with VKH. We report a case of a 12-year-old male with no significant past medical history who presented during the chronic stage of incomplete VKH. He was found to have a complete loss of photoreceptor layer in both eyes during a work-up to confirm the aforementioned disease. Upon receiving his first pulse dose of 500 mg IV methylprednisolone as a treatment course, he developed severe steroidinduced hyperglycemia (random blood glucose of 17.6 mmol/L). Additionally, a brain MRI revealed pituitary gland changes compatible with diabetes insipidus, which is a combination that was mentioned once in the literature before. A review of the systems did not suggest any other systemic diseases. The patient's elevated blood sugar level was managed by a pediatrician, and it normalized. At his last visit, optical coherence tomography (OCT) showed hypertrophy/regeneration of the photoreceptor layer. This case report indicates that retinal photoreceptor layer regeneration can be sometimes observed with follow-up after the resolution of inflammation and uveitis.

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Section: Discussionmentioning

confidence: 99%

Bilateral Complete Loss and Partial Regeneration of Photoreceptor Layers in a Pediatric Vogt-Koyanagi-Harada (VKH) Case

Aldossari¹,

Alhussaini²,

Barri³

et al. 2022

Cureus

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“…Other treatment options include immunosuppressants such as azathioprine, cyclosporine, methotrexate and the use of immunoglobulins [3,5], and the use of monoclonal antibodies such as adalimumab has been documented, which is associated with a lower risk of recurrence and visual impairment [6].…”

Section: Systemic Manifestationsmentioning

confidence: 99%

“…A simple skull tomography was performed where there is no evidence of pathology, lumbar puncture was performed to study cerebrospinal fluid with report of rock water appearance, proteins 62 mg/dl, glucose 73 mg/dL (central glycaemia 84 mg/dL), 138 cells per mm 3 , 70% mononuclear, Gram stain, negative.…”

Section: Case Reportmentioning

confidence: 99%

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Vogt-Koyanagi-Harada Incomplete Disease: A Case Report

Esparza¹,

Gurrola²,

Alba³

2018

Intern Med

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Introduction: Vogt-Koyanagi-Harada disease is a systemic autoimmune disease characterized mainly by a bilateral granulomatous panuveitis, in which antibodies are produced against tissues rich in melanocytes such as the retina, inner ear, meninges, skin, and hair, which explains its extraocular manifestations and its clinical presentation. Case report: A 27-year-old Mexican woman presented with sudden reduced visual acuity, with no history of trauma or eye surgery, without evidence of another ocular disease, she also presented meningism and disacusia. Retinal detachment is evidenced with the help of imaging studies, in addition to cerebrospinal fluid pleocytosis. The final diagnosis during her stay in the hospital was VKH disease. Discussion: The clinical case presented, based on current criteria for the diagnosis and classification of VKH disease is an incomplete VKH, and it was not possible to demonstrate the dermatological involvement in future stages to classify it as a complete VKH disease. Conclusion: VKH disease is difficult to diagnose, because its diagnostic criteria are mainly exclusion and its clinical presentation is variable and insidious, which results in a generally late diagnosis and treatment, allowing the appearance and progression of sequelae. Possibly, the diagnostic criteria for VKH disease should be subjected to a new review, to specify the most frequent clinical data in recent years, since they were published almost a couple of decades ago.

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